The Kerala High Court has directed the State government to issue within three months an order regulating sex-selective surgeries on intersex infants and children.
The court passed the directives while disposing of a writ petition filed by the parents of a child born with ambiguous genitalia seeking permission of the court to conduct a genital reconstructive surgery on the child.
The court directed the government to constitute a State-level multidisciplinary committee consisting of:
Paediatrician/ paediatric endocrinologist
Child psychiatrist/ child psychologist
To decide whether the child was facing any life-threatening situation by reason of the ambiguous genitalia. If so, permission could be granted for carrying out the surgery.
The court observed that a grant of permission for conducting genital reconstructive surgery would impinge on the rights guaranteed under the Constitution and that conduct of the surgery without consent would violate the child’s dignity and privacy.
Granting such permission may also result in severe emotional and psychological issues if, on attaining adolescence, the child developed an orientation towards the gender, other than the one to which the child was converted through surgical intervention.
It pointed out that the definition of transgender in Section 2(k) of the Transgender Persons (Protection of Rights) Act took in persons with intersex variations also, thereby making the protections under the Act available to such persons.Section 4(2) of the Act guaranteed the right to have a self-perceived gender identity. Thus, it was beyond cavil that the right to choose gender was vested with the individual concerned and no one else, not even the court.
"Sex-selective surgeries" generally refer to medical procedures that are performed with the intention of selecting the sex of a child or altering the physical characteristics of a person's sex.
There are several types of procedures that could fall under this category:
Sex Reassignment Surgery (SRS) or Gender Confirmation Surgery (GCS): These are surgical procedures intended to change a person's physical characteristics to align with their gender identity. For transgender individuals, these surgeries can include procedures like genital reconstruction, breast augmentation or removal, and facial surgeries. These procedures are not typically performed for the purpose of selecting a sex but rather aligning with an individual's gender identity.
Preimplantation Genetic Diagnosis (PGD): PGD is a technique used in assisted reproductive technology to select embryos for implantation based on genetic characteristics, including sex. This can be used to avoid passing on certain genetic disorders linked to a specific sex, but it can also be controversial if used solely to select a preferred sex.
Prenatal Screening and Diagnostic Tests: Certain prenatal tests can determine the sex of a fetus. While these tests are often used to screen for genetic disorders or to monitor the health of the fetus, they could potentially be used to selectively terminate pregnancies based on the sex of the fetus, a practice that is illegal and unethical in many places.
Non-medical Female Genital Mutilation (FGM) or Cutting: FGM refers to a range of procedures that involve altering or injuring the female genitalia for non-medical reasons. It is often performed as a cultural practice, although it is harmful and has no medical benefits.
It's important to note that there are ethical, cultural, and legal considerations surrounding sex-selective procedures.
In some cases, these procedures can reinforce harmful gender stereotypes and inequalities, contribute to gender-based discrimination, and lead to imbalanced sex ratios in certain populations.
It's always recommended to prioritize medical procedures that prioritize the well-being, autonomy, and informed choices of individuals while respecting cultural, ethical, and legal frameworks.
Sex-selective surgeries can give rise to several ethical, social, and cultural issues, depending on the context and purpose of the surgeries.
Key issues associated with such procedures:
Gender Bias and Discrimination: Sex-selective surgeries can reinforce harmful gender stereotypes and contribute to gender-based discrimination. The preference for a particular sex can reflect societal biases and perpetuate unequal treatment and opportunities for individuals of different genders.
Imbalance in Sex Ratios: In some cultures, and societies, a strong preference for one sex over the other can lead to imbalanced sex ratios, where there are significantly more individuals of one sex than the other. This can have long-term consequences for social dynamics, marriage patterns, and overall societal stability.
Violation of Autonomy: Performing sex-selective surgeries on individuals without their informed consent can violate their autonomy and bodily integrity. For instance, subjecting an intersex child to non-consensual surgeries to conform to a specific binary sex can result in physical and psychological harm.
Cultural and Religious Considerations: In certain cultures, and religions, there may be strong beliefs and traditions associated with gender roles and expectations. Performing sex-selective surgeries might clash with these cultural and religious values and lead to tensions or conflicts.
Medical Risks and Informed Consent: Some sex-selective surgeries can carry medical risks and complications. If these procedures are performed without proper medical evaluation, informed consent, and adherence to best practices, individuals can suffer physical and psychological harm.
Erosion of Diversity: Celebrating and valuing diversity in gender identities and expressions is important for promoting inclusivity and understanding. Sex-selective surgeries can contribute to a binary understanding of gender, overlooking the rich diversity of gender identities that exist.
Reproductive Freedom: In the context of reproductive technologies, selecting embryos based on sex could raise concerns about reproductive freedom and autonomy. If sex selection becomes routine, it might lead to societal pressure or expectations regarding the "desired" sex of a child.
Ethical Concerns in Genetic Manipulation: When sex selection is achieved through genetic manipulation, such as through gene editing techniques, it raises broader ethical questions about manipulating human genetics for non-medical purposes.
Global Consequences: In regions with imbalanced sex ratios due to sex-selective practices, there can be international implications, such as migration of individuals seeking partners or opportunities in areas with more balanced sex ratios.
To address these issues, it's important to engage in open conversations about gender, culture, and ethics, and to prioritize the rights and well-being of individuals. Ethical guidelines, laws, and policies can also play a role in regulating the use of sex-selective procedures to ensure that they are carried out responsibly and with respect for human rights.